Survey of dentists to determine contemporary use of endodontic posts

Although the scientific literature provides sound decision-making tools for the restoration of endodontically treated teeth, dentists have different opinions on the rationale for the use of endodontic posts (dowels) and selection of post systems. The decision to place a post is at times contrary to the literature. Updated information on the treatment of endodontically treated teeth among general dentists is lacking.

The purpose of this survey was to gain insight into the rationale for choice of endodontic posts and the different endodontic post systems currently used by dental practitioners. Post and core restorations distribute stress and replace missing tooth structure in endodontically treated teeth. Guidelines exist to help select post systems. With the advent of new materials, prefabricated posts have gained popularity among dentists. However, cast-metal post-and-core systems are still considered the gold standard.

Surveys were distributed to dentists attending continuing education meetings in the United States, Canada, Scotland, Ireland, and Greece. The questions addressed years of practice, specialty training, and brand, type, shape, and material of the endodontic post systems used.

Descriptive statistical analysis was used to assess the percentage of respondents. Ninety-two percent of the participants were general practitioners with 25.94 ±13.35 years of experience. The majority agreed upon using endodontic posts when insufficient coronal tooth structure remains and for stress distribution. Passive, parallel posts were the most commonly reported type and shape. With regard to post material, fiber posts were the most frequently used (72.2%), followed by prefabricated alloys (38.6%), cast-metal posts (33.9%), prefabricated titanium posts (30.1%), and stainless-steel posts (21.7%). For cementation, resin-modified glass ionomer (40%) was most frequently used, followed by self-adhesive resin (29.6%).

The majority of the practitioners used fiber posts. This may be because, in terms of fracture, they compare favorably with cast-metal post and core, although little evidence in the literature validates this claim.